Psychology News & Resources

The recent controversy over the still-developing DSM-5 — that compendium of mental disorders the media love to call, inappropriately, “The Bible of Psychiatry” –has gotten me thinking about loneliness. Now, thankfully, nobody has seriously proposed including loneliness in the DSM-5. Indeed, loneliness is usually thought of as simply an unpleasant part of life — one of the “slings and arrows” that pierce almost all of us from time to time. Loneliness, in some ways, remains enmeshed in a web of literary and cultural clichés, born of such works as Nathaniel West’s darkly comic novel, Miss Lonelyhearts, and the Beatles’ whimsical anthem, “Sgt. Pepper’s Lonely Hearts Club Band.”

But loneliness turns out to be a serious matter. And as psychiatry debates the diagnostic minutiae of DSM-5, all of us may need to remind ourselves that millions in this country struggle against the downward tug of loneliness. Yet even among health care professionals, few seem aware that loneliness is closely linked with numerous emotional and physical ills, particular among the elderly and infirm.

It’s easy to assume that loneliness is simply a matter of mind and mood. Yet recent evidence suggests that loneliness may injure the body in surprising ways. Researchers at the University of Pittsburgh School of Medicine studied the risk of coronary heart disease over a 19-year period, in a community sample of men and women. The study found that among women, high degrees of loneliness were associated with increased risk of heart disease, even after controlling for age, race, marital status, depression and several other confounding variables. (In an email message to me, the lead author, Dr. Rebecca C. Thurston, PhD, speculated that the male subjects might have been more reluctant to acknowledge their feelings of loneliness).

Similarly, Dr. Dara Sorkin and her colleagues at the University of California, Irvine, found that for every increase in the level of loneliness in a sample of 180 older adults, there was a threefold increase in the odds of having heart disease. Conversely, among individuals who felt they had companionship or social support, the likelihood of having heart disease decreased.

The young, of course, are far from immune to loneliness. Researchers at Aarhus University in Denmark studied loneliness in a population of adolescent boys with autism spectrum disorders (an area of great controversy in the proposed DSM-5 criteria). More than a fifth of the sample described themselves as “often or always” feeling lonely—a finding that seems to run counter to the notion that those with autism are emotionally disconnected from other people. Furthermore, the study found that the more social support these boys received, the lower their degree of loneliness. We have no cure for autism in adolescents–but the remedy for loneliness in these kids may be as close as the nearest friend.

And lest there be any doubt that loneliness has far ranging effects on the health of the body, consider the intriguing findings from Dr. S.W. Cole and colleagues, at the UCLA School of Medicine. These researchers looked at levels of gene activity in the white blood cells of individuals with either high or low levels of loneliness. Subjects with high levels of subjective social isolation—basically, loneliness — showed evidence of an over-active inflammatory response. These same lonely subjects showed reduced activity in genes that normally suppress inflammation. Such gene effects could explain reports of higher rates of inflammatory disease in those experiencing loneliness.

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Could inflammatory changes, in turn, explain the correlation between loneliness and heart disease? Inflammation is known to play an important role in coronary artery disease. But loneliness by itself may be just one domino in the chain of causation. According to Dr. Heather S. Lett and colleagues at Duke University Medical Center, the perception of poor social support — in effect, loneliness — is a risk factor for development, or worsening, of clinical depression. Depression may in turn bring about inflammatory changes in the heart that lead to frank heart disease. This complicated pathway is still speculative, but plausible.

Loneliness, of course, is not synonymous with “being alone.” Many individuals who live alone do not feel “lonely.” Indeed, some seem to revel in their aloneness. Perhaps this is what theologian Paul Tillich had in mind when he observed that language “… has created the word “loneliness” to express the pain of being alone. And it has created the word “solitude” to express the glory of being alone.” Conversely, some people feel “alone” or disconnected from others, even when surrounded with people.

Let’s admit that not everybody is capable of experiencing the “glory of being alone” or of transforming loneliness into “solitude.” So what can a socially-isolated person do to avoid loneliness and its associated health problems? Joining a local support group can help decrease isolation; allow friendships to form; and give the lonely person an opportunity both to receive and to provide help. This reciprocity can bolster the lonely person’s ego and improve overall well-being. Support groups geared to particular medical conditions can also help reduce disease-related complications. Although there are always risks in going “on line” to find support, Daily Strength appears to be a legitimate and helpful website for locating support groups of all types, including those for loneliness. Psych Central also provides opportunities to exchange ideas and “connect” with many individuals who feel isolated or alone. For those who feel lonely even in the midst of friends, individual psychotherapy may be helpful, since this paradoxical feeling often stems from a fear of “getting close” to others.

No, loneliness is not a disease or disorder. It certainly shouldn’t appear in the DSM-5 — but it should be on our minds, as a serious public health problem. Fortunately, the “treatment” may be as simple as reaching out to another human being, with compassion and understanding.

Early onset of sexual activity among teens may relate to the amount of adult content children were exposed to during their childhood, according to a new study released by Children’s Hospital Boston. Based on a longitudinal study tracking children from age six to eighteen, researchers found that the younger children are exposed to content intended for adults in television and movies, the earlier they become sexually active during adolescence. The findings are being presented at the Pediatric Academic Societies meetings on Monday, May 4 in Baltimore.

“Television and movies are among the leading sources of information about sex and relationships for adolescents,” says Hernan Delgado, MD, fellow in the Division of Adolescent/Young Adult Medicine at Children’s Hospital Boston and lead author of the study. “Our research shows that their sexual attitudes and expectations are influenced much earlier in life.”

The study consisted of 754 participants, 365 males and 389 females, who were tracked during two stages in life: first during childhood, and again five years later when their ages ranged from 12 to 18-years-old. At each stage, the television programs and movies viewed, and the amount of time spent watching them over a sample weekday and weekend day were logged. The program titles were used to determine what content was intended for adults. The participants’ onset of sexual activity was then tracked during the second stage.

According to the findings, when the youngest children in the sample–ages 6 to 8-years-old–were exposed to adult-targeted television and movies, they were more likely to have sex earlier when compared those who watched less adult-targeted content. The study found that for every hour the youngest group of children watched adult-targeted content over the two sample days, their chances of having sex during early adolescence increased by 33 percent. Meanwhile, the reverse was not found to be true that is, becoming sexually active in adolescence did not subsequently increase youth’s viewing of adult-targeted television and movies.

“Adult entertainment often deals with issues and challenges that adults face, including the complexities of sexual relationships. Children have neither the life experience nor the brain development to fully differentiate between a reality they are moving toward and a fiction meant solely to entertain,” adds David Bickham, PhD, staff scientist in the Center on Media and Child Health and co-author of the study. “Children learn from media, and when they watch media with sexual references and innuendos, our research suggests they are more likely to engage in sexual activity earlier in life.”

The researchers encourage parents to follow current American Academy of Pediatrics viewing guidelines such as no television in the bedroom, no more than 1 to 2 hours of screen time a day, and to co-view television programs and have an open dialogue about its content with your children. They also suggest that–while the results demonstrate a longitudinal relationship–more research needs be done to understand how media influences children’s growing awareness of human relationships and sexual behavior.

“Adolescent sexual behaviors may be influenced at a younger age, but this is just one area we studied,” adds Dr. Delgado. “We showed how adult media impacts children into adolescence, yet there are a number of other themes in adult television shows and movies, like violence and language, whose influence also needs to be tracked from childhood to adolescence.”

The study was funded by support by grants from the Maternal and Child Health Bureau and the Center on Media and Child Health.

Children’s Hospital Boston is home to the world’s largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 500 scientists, including eight members of the National Academy of Sciences, 11 members of the Institute of Medicine and 13 members of the Howard Hughes Medical Institute comprise Children’s research community. Founded as a 20-bed hospital for children, Children’s Hospital Boston today is a 397-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children’s also is the primary pediatric teaching affiliate of Harvard Medical School.

About Peter

Peter Brown BHMS (Hons) MPsychClin MAPS

I’m a Clinical Psychologist and have a private practice and consultancy in Brisbane Australia. I have 24 years experience in child, adult and family clinical psychology. I have a wonderful wife and three kids.

I like researching issues of the brain & mind, reading and seeking out new books and resources for myself and my clients. I thought that others might be interested in some of what I have found also, hence this blog…